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血清维生素 D 水平与腹型肥胖的关系:系统评价和流行病学研究的剂量反应荟萃分析。

Serum vitamin D levels in relation to abdominal obesity: A systematic review and dose-response meta-analysis of epidemiologic studies.

机构信息

Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Obes Rev. 2021 Feb;22(2):e13134. doi: 10.1111/obr.13134. Epub 2020 Sep 3.

Abstract

Although several observational studies have investigated the relationship between vitamin D deficiency and risk of central obesity, the results were inconsistent. We performed a dose-response meta-analysis on epidemiologic studies that evaluated the association of vitamin D status and abdominal obesity in adults. A systematic search was carried out of all published articles, up to May 2020, in five electronic databases, including MEDLINE (Pubmed), EMBASE, Institute for Scientific Information (ISI) (Web of science), Scopus and Google scholar. Forty-one observational studies reported odds ratios (ORs) or relative risks (RRs) with 95% confidence intervals (CIs) for abdominal obesity in relation to serum vitamin D levels in adults were included in the analysis. Using a random effects model, the overall effect size was calculated. Combining 44 effect sizes from 36 cross-sectional studies with 257,699 participants revealed that the highest versus the lowest serum vitamin D level was significantly associated with a 23% decreased odds of abdominal obesity (OR: 0.77; 95% CI [0.71, 0.83]). This inverse association was significant in almost all subgroups based on different covariates. Dose-response analysis showed that each 25 nmol/L increase in serum vitamin D was related to 8% reduced risk of abdominal obesity (OR: 0.92; 95% CI [0.85, 0.99]). When we confined the analysis to 23 effect sizes from 17 studies with representative population (242,135 participants), the same results were obtained (OR: 0.79; 95% CI [0.71, 0.87]). Dose-response analysis indicated that each 25 nmol/L increase in blood vitamin D levels was linked to 10% decreased central adiposity risk in representative populations (OR: 0.90; 95% CI [0.82, 0.99]). This meta-analysis of epidemiologic studies revealed that serum vitamin D level was inversely associated with risk of abdominal obesity in adults, in a dose-response manner. The same findings were obtained in representative populations. Further prospective studies are required to examine the causal association between serum vitamin D levels and abdominal obesity.

摘要

尽管有几项观察性研究调查了维生素 D 缺乏与中心性肥胖风险之间的关系,但结果不一致。我们对评估成人维生素 D 状态与腹部肥胖之间关系的流行病学研究进行了剂量-反应荟萃分析。系统检索了截至 2020 年 5 月在五个电子数据库中发表的所有文章,包括 MEDLINE(PubMed)、EMBASE、科学信息研究所(ISI)(Web of Science)、Scopus 和 Google Scholar。纳入了 41 项观察性研究,这些研究报告了成人血清维生素 D 水平与腹部肥胖相关的比值比(OR)或相对风险(RR)及其 95%置信区间(CI)。使用随机效应模型计算总体效应大小。结合 36 项横断面研究中 44 个效应量和 257699 名参与者的数据,结果表明,血清维生素 D 水平最高与最低组相比,腹部肥胖的几率降低 23%(OR:0.77;95%CI[0.71,0.83])。根据不同的协变量,这种反比关系在几乎所有亚组中均具有统计学意义。剂量-反应分析表明,血清维生素 D 每增加 25 nmol/L,腹部肥胖的风险降低 8%(OR:0.92;95%CI[0.85,0.99])。当我们将分析仅限于来自具有代表性人群(242135 名参与者)的 17 项研究中的 23 个效应量时,得到了相同的结果(OR:0.79;95%CI[0.71,0.87])。剂量-反应分析表明,在具有代表性的人群中,血液维生素 D 水平每增加 25 nmol/L,中心性肥胖的风险降低 10%(OR:0.90;95%CI[0.82,0.99])。本项流行病学研究的荟萃分析表明,血清维生素 D 水平与成人腹部肥胖风险呈负相关,且呈剂量-反应关系。在具有代表性的人群中也得出了相同的发现。需要进一步的前瞻性研究来检验血清维生素 D 水平与腹部肥胖之间的因果关系。

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